Articles: pain.
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The involvement of serotonergic mechanisms in diffuse noxious inhibitory controls (DNIC) acting on dorsal horn convergent neurones has been studied in the anaesthetized rat. 35 neurones activated by transcutaneous electrical stimulation of their hindpaw receptive fields giving clear large A-fibre and C-fibre responses were recorded. These activities were conditioned by DNIC, evoked by either noxious heat applied to the tail or noxious pinch of the nose. ⋯ These results indicate an important role for descending serotonergic pathways in DNIC. The functional role of this system is discussed.
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Ketamine hydrochloride 4 mg in 10 ml 5% dextrose water was administered epidurally to 7 patients suffering from intractable pain in the back, lower abdomen and legs. Pain relief was obtained in all cases. ⋯ No adverse side-effects were noted and no detectable neurological damage resulted. Intraspinal ketamine offers and advantage over the opiates, in that respiratory depression is unlikely to occur.
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Surg Gynecol Obstet · Mar 1982
Clinical Trial Controlled Clinical TrialEpidurally administered morphine for postcesarean analgesia.
A double blind study was performed to evaluate analgesia from epidurally injected morphine sulfate in 30 mothers after cesarean section following similar regional anesthetics. When compared with a saline placebo and 2 milligrams of epidurally injected morphine, a 4.5 milligram epidurally administered morphine dose resulted in a highly significant reduction in the initial 24 hour parenterally administered narcotic requirement, p less than 0.001, and a significantly greater duration of analgesia after epidural injection, p less than 0.0003. ⋯ No significant side-effects were noted. Epidurally administered morphine appears promising as a potent analgesic approach of extended duration with potential advantages for early maternal mobilization, improved fetal maternal interaction and reduced fetal narcotic exposure in the breast fed infant.